ANESTHESIOLOGY
OPERATOR PREFERENCE OF RETRACTION METHOD DURING ANESTHESIA DELIVERY
Bernadette Alvear Fa 1a * , Shika Gupta 1b , Mouchumi Bhattacharyya 2c
1
Department of Integrated Reconstructive Dental Sciences , School of Dentistry University of the Pacific Arthur A . Dugoni San Francisco , CA 94103 , USA
2
Department of Mathematics , University of the Pacific , Stockton , CA 95211 , USA a
DDS , Assistant Professor , Director of Local Anesthesia b
DDD , Assistant Professor c
Professor of Statistics
Cite this article : Alvear Fa B , Gupta S , Bhattacharyya M . Operator preference of retraction method during anesthesia delivery . Stoma Edu J . 2016 ; 3 ( 1 ): 10-15 .
ABSTRACT
Received : March 9 , 2016 Received in revised form : April 22 , 2016
Accepted : April 24 , 2016 Published online : March 09 , 2016
Introduction : Dental Health Care Providers ( DCPs ) traditionally use finger retraction or mirror retraction when delivering local anesthesia . Needlestick injuries ( NSIs ) occur as hand retracting mucosa is likely to experience injury during dental anesthesia delivery . The aim of this paper is to examine a clinical split mouth study comparing two retraction methods and DCP ’ s retraction preference during delivery of dental anesthesia . The clinical implications from this study impact the practitioner ’ s risk of experiencing an NSI . Methodology : The IRB approved study ( clinical trials ID : NCT02414620 ) compared the comfort and ease of the retraction method used while delivering an anterior superior alveolar ( ASA ) injection bilaterally . Surveys given to participants asked about comfort and ease of use of retraction methods , as well as preferred method of retraction during anesthesia delivery . Chisquare tests of goodness-of-fit were conducted to investigate whether there was a significant difference in the proportion of respondents that chose the various categories within one criterion . Results : 62 DCPs participated in the study and no reported NSIs . Data from the DCPs report significance ( p value < 0.001 ) in comfort comparing retraction methods when providing anesthesia . Regarding preference of retraction , 22 prefer mirror , 29 preferred device , and 3 preferred their finger . Regarding ease of retraction used , 30 chose mirror , 18 device , and 10 chose finger . Conclusion : Our hypothesis and clinical implication were confirmed . More studies need to be conducted regarding the benefits of using a fingerless retraction method and its effectiveness in dental anesthesia . Keywords : dental anesthesia , dental injection technique , dental armamentarium .
1 . Introduction
Dental Health Care Providers ( DCPs ) traditionally use finger retraction or mirror retraction when delivering local anesthesia . 1-3 Existing dental anesthesia curriculums and educational programs have not emphasized techniques other than using the finger for retraction of mucosa . 4-7 Literature presents cases of needlestick injuries ( NSIs ) when finger is used to retract mucosa to deliver anesthesia . 8 , 9 Innovations towards dental anesthesia delivery have progressed throughout the years . 1 , 4 , 10-13 In addition , various instruments exist both in clinical practice and on the market to aid in retraction ( cheek retractor , tongue depressor etc ). 1 , 14-16 In 2010 , a device was approved for purchase in the United States for use during dental anesthesia delivery ( Fig . 1 ). This device is a cordless , rechargeable , handheld system that delivers pulsed micro-oscillations to the injection site . The disposable retraction tips consisting of two rubber prongs with an illuminating LED light appropriate for the generation 2 model can be assembled onto the device prior to use . If the DCP applies too much pressure , the device will automatically shut down the oscillating pulses until an appropriate handle and pressure is applied . 17 The aim of this paper is to examine a clinical split mouth study comparing two retraction methods and DCP ’ s preference during delivery of dental anesthesia . Our hypothesis is that introducing a new device will provide an alternative method to aid in retraction during delivery of dental anesthesia . The clinical implications from this study
* Corresponding author : Assistant Professor Bernadette Alvear Fa , DDS , Director of Local Anesthesia Department of Integrated Reconstructive Dental Sciences , School of Dentistry University of the Pacific Arthur A . Dugoni 155 , 5th Street , San Francisco , CA 94103 , USA Tel / Fax : ( 415 ) 749 3373 , e-mail : balvear @ pacific . edu
10 STOMA . EDUJ ( 2016 ) 3 ( 1 )